A week ago, Emma Sullivan was simply another high school student in Topeka, Kansas. She had her circle of friends and family like all high school students. She was attending a Kansas Youth in Government program where Governor Sam Brownback addressed her and her fellow students. Sometime during this conference she tweeted: Just made mean comments at gov brownback and told him he sucked, in person #heblowsalot. Okay, no big deal, just a high school student expressing herself. Then, somebody from the governor’s office called the principal of her school. Let’s just think about this just for second. A high school student says something to the governor. As far as I know, she hasn’t broken any laws and hasn’t violated any code of conduct that I know of. Why would somebody from the governor’s office run whining to the principal’s office? Why would the principal’s office pay any attention to it? According to Emma Sullivan, the high school student, she was ordered by the principal to write letters of apology to Governor Brownback, the school’s Youth in Government sponsor and several other recipients.

This morning Emma tweeted “I’ve decided not to write the letter but I hope this opens the door for average citizens to voice their opinion & to be heard! #goingstrong.” Would you or would you not agree that we should all have the right to criticize our political leaders? She does not have the right to be rude, but she does have the right to express herself in a way that does not disrupt the class or the learning activity. If she’s able to do this, there’s no reason for the governor’s office to be offended. There’s no reason for the principal’s office to get involved.

Update: Finally, some common sense (and I didn’t think that Governor Brownback had any!)

In the uproar over a Prairie Village teenager’s tweet about Kansas Gov. Sam Brownback during a school trip, it is the governor who is apologizing. “My staff over-reacted to this tweet, and for that, I apologize. Freedom of speech is among our most treasured freedoms,” said a statement from Brownback’s office.

Overreacted, indeed. Ya think?

So let’s see. A teenager tweeted that her governor sucks. He does in fact suck, as is evidenced by his staff obsessively compiling an enemies list of teenage girls who don’t like him on Twitter. His staff complains, the school principal freaks out, probably correctly figuring that Brownback’s office will use it as excuse to cut their pencil budget again, this time down to one pencil per thirty kids, and tells the teenage girl she has to apologize. The wider world finds out about it, floods all parties with messages of support for the teenager in question and suddenly everybody remembers the First Amendment again.

When did the government begin to try and take over what we eat and what doctor we use? When did that start?

When did it become fashionable to make too much money, to work too hard and do really well for your family?

When did it become good business sense for the country to own two of the three American auto manufacturers?

When did it start making good business sense for the U.S. to hold preferred stock positions in small local banks as the new small business stimulus allows?

When did it become fiscally responsible to have to borrow just to pay interest on the National Debt?

When did it become fiscally responsible governing to owe so much money to a country like China?

When did we become a nation that WE THE PEOPLE said to do what we wanted, and that was ignored by those we voted into office?

I’m going to attempt to answer a few these questions today and I’m going to leave a few of them for later on. Let’s look at the first question, when did the government try and take over what we eat? As far as I know this never happened. I guess what the author is referring to is the fact that the government is suggesting that we eat healthier. Isn’t it in our government’s best interest for its citizens to be healthier? Doesn’t it cost all of us more if we can’t curb the costs of Medicare and Medicaid? The answer is of course. Instead of honestly looking at the question, the author is posing this as some sort of invasion of personal rights, an extension of the government into our private lives. The food pyramid been around for over 20 years. The food pyramid replaced “food groups” which are classified by types and nutrition. This has been around since the 1980s, yet the author of this question seems to be pointing a finger at President Obama for designing something so intrusive. Nothing could be further from the truth. Conservatives jump up and down about government spending but when progressives try to do something about the rising costs conservatives will have none of it.

Let’s look at the rising cost of obesity. According to the CDC, Americans spent $92.6 billion in 2003 on obesity and obesity-related illnesses. This would include diabetes, hypertension, cardiovascular diseases, strokes, renal failure, skin infections, loss of eyesight (in relation to diabetes) and many other diseases. Multiple studies have clearly shown that prevention costs significantly less than treatment. So, let me ask the question again. Why wouldn’t it be in our best interest for all of us to eat healthier?

Many of us do not see the problem in our society. I would say that the problem is rampant and then relate the tale of one single patient whom I took care of some years ago. She and her family had been out on a boat and got severely sunburned. The four-year-old daughter, who was sunburned basically from head to toe, was morbidly obese. I placed the child in the hospital for pain control and care of her burns. I sent pediatrics to see the patient and to counsel the family on nutrition. The pediatrician asked the mother if she ever fed her child any fruit. The mother replied, yes, enthusiastically. She then went into her purse and pulled out a fruit rollup. Now, before you roll your eyes, go out to your local mall and just sit down on a bench and watch the crowd. What percentage of kids are obese? I’m not talking about kids that are just a little chubby. I’m talking about obese. We have to fix this. BTW, do you think that this patient’s family could benefit from some nutritional information?

The second part of the question is simply sad. The question is – when did the government began to try and take over what we eat and what doctor we use? What doctor we use? The government has never tried to tell us which doctor we use. Never. This is been reiterated over and over during the health-care debate by both President Obama and others who are pushing for reform. You can choose your own doctor. Quoting from HealthCare.gov – “You select the doctor: The new rules permit you to choose any available participating primary care provider as your doctor and to choose any available participating pediatrician as your child’s primary care doctor.”

More on these questions later. What are your thoughts? Are these questions specifically designed to elicit an emotional response or do you think are they designed to elicit a thoughtful discussion about the role of our government and our society?

A few months ago a doctor asked me why hedge fund managers make more money than he and his colleagues. After all, Doctor, when used before a name, is capitalized, while hedge fund manager isn’t. While I’m joking about the capitalization — it does reflect the much greater level of societal acclamation doctors receive from the moment they set their minds on an MD to their obituaries. So why doesn’t societal acclamation translate into money?

Before trying to answer this question, it’s worth noting that I just spent some time trying to find a list of the highest paid doctors — but I failed. I found one list which said surgeons make an average of $247,536– and a 1999 survey suggesting that neuro-surgeons make $500,000. But hedge fund managers do get ranked by income, as this New York Times article (registration required) points out.

My post on top-ranked James Simons (2006 income: $1.7 billion), suggested hedge fund managers out-earn doctors because top performing hedgies can leverage their time more efficiently. That is — while a hedge fund manager can take on an additional $1 billion under management without adding a huge number of additional analysts, if a doctor takes on many more patients, he or she will need to hire a proportionately larger number of doctors to treat them. Most hedge fund managers let computers do much of the work — something doctors can’t do.

But there’s really more to it than that — society perceived that the pricing mechanism for doctors’ services was broken. That is, if the free market set the price, many citizens would not be able to afford to pay. And society believes implicitly that health care should be widely available to citizens. (That doesn’t mean everybody. 40 million Americans are not covered by health insurance but many of them can get care at hospital emergency rooms.) (more…)

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Errington C. Thompson, MD

Dr. Thompson is a surgeon, scholar, full-time sports fan and part-time political activist. He is active in a number of community projects and initiatives. Through medicine, he strives to improve the physical health of all he treats.

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